Name: Michael J Kim

Theme: Leukaemia and complications

OPTION LIST

A	Acute Lymphoblastic Leukaemia	I	Hypothyroidism
B	Acute Myeloid Leukaemia	J	Lung Fibrosis
C	Acute Promyelocytic leukaemia	K	Mikee Mouse Syndrome
D	Bronchial Carcinoma	L	Richter’s Syndrome
E	Chronic Lymphocytic Leukaemia	M	Septicaemia
F	Chronic Myeloid Leukaemia	N	Tumour-Lysis Syndrome
G	DIC	O	Vincristine poisoning
H	Hairy Cell Leukaemia	P

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 64-year old woman receiving long-term chemotherapy for lymphoma presents with worsening bone pain, recurrent fever and night sweats. Blood film shows blast cells with Auer rods.

2. A 61-year-old man with CLL presents with recurrent pneumonia and haemoptysis. On fibreoptic bronchoscopy, the patient is found to have an endobronchial mass. The biopsy shows anaplastic, large cell lymphoma.

3. A newly diagnosed ALL patient complains of tiredness, polyuria, polydipsia, abdominal pain and vomiting on receiving chemotherapy. On examination, BP: 160/100mmHg, temp: 39ºC, and ECG shows tented T waves. Blood test shows serum K⁺: 6.9mmol/L and phosphate: 7.1 mmol/L. The patient later dies of cardiac arrest.

4. A routine medical of 33-year-old footballer reveals: Hb = 9.9g/dl and WCC = 130 x 10⁹/L. His blood film shows whole spectrum of myeloid precursors, including a few blast cells. He admits to having frequent night sweats and blurred vision. There is a presence of Ph chromosome t(9;22) on cytogenetic analysis.

5. A 5-year-old girl presents with failure to thrive, recurrent fever and bruising. Immunotyping reveals the presence of CD10.

ANSWERS

1. B

2. L

3. N

4. F

5. A